Eating disorders, particularly anorexia and bulimia, are usually covered by health insurance, partly as a result of the "parity law" now in effect in California, but figuring out exactly what the coverage is can be confusing. The parity law states that certain mental health disorders, including anorexia and bulimia, will have the same maximum co-payment as those in the general medical plan. This short guide will give you some basic information to help you get the benefits to which you are entitled and also to make decisions about maintaining insurance coverage for the future.
First, you should review and be aware of the details of your policy and contract. The major insurance companies vary tremendously as to what they will cover, and every insurance company has hundreds of different policies, each with its own coverage and terms. In addition, major insurance companies often have mental health benefits, under which eating disorders coverage falls, administered by a secondary company. The best way to be clear about your benefits and your payment responsibilities is to actually read all the information sent to you about your plan, as well as any updates. While reviewing all the specifics of your policy may seem like a daunting and unpalatable task, it is well worth the time since treatment of eating disorders can be very costly.
If you still have questions about your coverage after reviewing the policy, contact your health insurance company for further explanations. Ask to speak to the insurance company representative’s supervisor for further clarification if the answers you are given do not seem to fit with the terms of your policy as you understand it. You can also ask for help from your employer's human resources department.
Remember that you are your own best advocate when dealing with your health insurance coverage issues. You should also be aware that all insurance companies have an appeal process whenever a claim is denied, and in some cases denials of coverage are overturned on appeal.
As the parent of a son or daughter with an eating disorder, you should keep in mind the issue of ongoing, long-term health insurance coverage. It is especially important that a person with any serious or pre-existing medical condition, which includes anyone with an eating disorder, never let health insurance coverage lapse. It is likely to be difficult and extremely expensive, if not impossible, to obtain or reinstate new insurance coverage. If your child's insurance coverage is due to end because a parent changes jobs or is laid off, or because the child will pass the age under which they are covered, be sure to check with your health insurance company and your company's human resources department to find out how coverage can be continued. You can also contact an insurance agent to find out what options you may have for health insurance, but be sure to explain fully your child's medical history.
Again, make certain that you consider and settle this question before your child's coverage ends, so that there will be continuous insurance coverage.
